2 BIOMATERIAL“When a material is placed within, or in contact with the human body, it is referred to as biomaterial”OR“A non living material designed to interact with the biological system”

3 BIOCOMPATIBILITY Defined as,“The ability of a material to elicit an appropriate biological response in a given application in the body.”The material is said to be “biocompatible” when it possesses the property of being non destructive in a biological system.

4 BIOMECHANICS“Behavior of a material in real structures is known as mechanics”“Biomechanics is application of mechanics to biomaterials”Biomechanics involve.Limitation of a material.Restorative design.

5 ADVERSE EFFECTS FROM DENTAL MATERIALSAdverse effects may be,Toxic.Inflammatory.Allergic.Mutagenic.These effects are differentiated on the basis of histological and pathological analysis of tissues.

7 INFLAMMATION Second type. Activate immune response of the host.May be due to toxicity or allergy.Inflammation precedes toxicity.e.g.Pulpal and Periodontal diseases.

8 ALLERGY Most Familiar to the general public.Body specifically recognizes a material as a foreign body and reacts disproportionately to the amount of material.Involves all the dimensions of the immune system.Can be difficult to differentiate from non-allergic inflammation or low grade toxicity.E.g. Latex.

9 MUTAGENIC REACTIONOccurs when the components of the materials alter the base pair sequence of DNA.May be due to direct / indirect interactions.Does not imply carcinogenicity.Metal ions from a dental material (nickel, beryllium and copper)

10 LOCAL and SYSTEMIC EFFECTS OF MATERIALSLOCAL EFFECTS:Occur in the pulp of the tooth, periodontium, nearby mucosa or root apex.Depends upon the ability of material.E.g. Nickel containing crowns.

11 LOCAL and SYSTEMIC EFFECTS OF MATERIALSDue to substances that gain access to the body.ingestion and absorption from the gut, inhaled vapor, absorption through oral mucosa or release from the tooth apex.

12 LOCAL and SYSTEMIC EFFECTS OF MATERIALSMay occur by blood or lymphatic transport or simply by diffusion.Systemic effect depends upon,Duration and concentration of exposure.Excretion rate of substance.Site of exposure.

13 MEASURING BIOCOMPATIBILITY OF DENTAL MATERIALSBiological response is related to the use of a material.Factors affecting biological response:Location of the material.Duration of the material in the body.Stresses placed on the materials.

14 Location of the materialSurroundings can be a soft tissue or a hard tissue.May be exposed directly to the blood, tissue fluids or saliva or through a barrier.Might be placed externally or internally to the oral epithelium.

15 2. Duration of the material in the bodyMay be:1. Short duration-> 4 – 6 minutes.e.g. Impression materials.2. Longer duration-> for ten years.e.g. Fixed prosthesis.Longer duration provides more time to the material and body to react to each other.

16 3. Stresses placed on the materialsStresses may be physical, chemical or thermal.Properties of the material comes under consideration.E.g. Strength of a material.Fatigue stresses .

19 1. IN VITRO TEST Performed outside the organism.First screening test to evaluate biological response of a new material.Conducted in test tube, cell culture dish, flask or other container.Contact may be direct/indirect.

21 2. THE ANIMAL TEST Material placed into an intact organism.Commonly used animals are mice, rats, hamsters or guinea pigs.Other animals used are cats, sheep's, dogs, monkeys and baboons.Distinct from usage tests.

22 2. THE ANIMAL TEST Intact biological system.ADVANTAGESIntact biological system.Act as a bridge between in vitro and usage test.DISADVANTAGESExpansive.Difficult to control.May take months or years.Ethical concerns.

23 3. USAGE TEST Performed in animals or humans.In case of humans it is called as clinical trial.Choice of animal is limited.Animals used should be large, with anatomy similar to the humans.Human clinical trial is the “gold standard”.

27 TESTS USED TOGETHER Often in vitro.PRIMARY PHASEPerformed initially for testing a new material.Often in vitro.May also include some animal tests for systemic toxicity.

28 TESTS USED TOGETHER Always conducted in animals.SECONDARY PHASEAlways conducted in animals.Used to rule out any dermal irritation, chronic toxicity or response upon implantation.Can also rule out inflammation, allergy and sub lethal biological responses.USAGE PHASE:-Same as discussed previously

31 CURRENT BIOCOMPATIBILTY ISSUES IN DENTISTRYNickel:But only 33% of individuals allergic to nickel will be allergic to palladium.Etiology not known.Beryllium:Only used in 1% – 2% by weight in Ni-Cr alloy.Carcinogenic effects.Can cause “beryllosis”.